Benefit of a laparoscopic jejunostomy feeding catheter insertion to prevent bowel obstruction associated with feeding jejunostomy after esophagectomy

Abstract

Abstract The proximity of the jejunostomy site to the midline might be associated with bowel obstruction, and we have introduced laparoscopic jejunostomy (Lap-J) to reduce jejunostomy’s left lateral gap. We evaluated 165 patients who underwent esophagectomy for esophageal cancer between February 2013 and November 2022 to clarify the benefits of Lap-J compared to other methods. The patients were classified into three groups according to the method of feeding catheter insertion: jejunostomy via small laparotomy (J group), gastroduodenostomy (GD group), and laparoscopic jejunostomy (Lap-J group). The J, GD, and Lap-J groups included 79, 69, and 17 patients, respectively. Surgery for bowel obstruction associated with the feeding jejunostomy catheter (BOFJ) was performed on 11 in the J group. Comparing the J and Lap-J groups, the distance between the jejunostomy and midline was significantly longer in the Lap-J group (50 mm vs. 102 mm; P < 0.001). Regarding surgery for BOFJ, the distance was significantly shorter in the surgery group than in the non-surgery group (43 mm vs. 52 mm; P = 0.040). During esophagectomy, Lap-J can prevent BOFJ by placing the jejunostomy site at the left lateral position to the midline and reducing the left lateral gap of the jejunostomy.